Tag: private duty nursing

Last week, Hearts for Home Care members and BAYADA employees Dave Totaro, Tara Montague, and Alisa Fox traveled to northern New Jersey to meet two home care clients and their caregivers to learn more about how home care has impacted their lives and how they advocate on behalf of themselves and their loved ones.

Meeting Addy and Gloria

Photo: DOV client Addy R. and her HHA Gloria have an unbreakable bond

First, the team stopped by a BAYADA service office in Dover,
NJ to meet the staff and learn about the struggles the office regularly faces
in recruiting and retaining home health aides. Per staff member Helena Anton, challenges
lie primarily within staunch competition in the area and finding the high-quality and compassionate caregivers that
“you can tell are put on this earth to care for others,” as Helena puts it.

“Smaller home health care companies can usually pay the
caregiver more in wages because we put that money into benefits, training, and
supplies. But the real problem is that Medicaid
reimbursement rates are so low that these caregivers—no matter what company
they work for—aren’t making enough. That’s why we need to advocate to make sure
the state sees how low wages are impacting so many New Jerseyans that are able
to live and their communities and thrive with home care,” added Helena.

After the discussion, the Hearts for Home Care advocates met
home care client Addy and her aide Gloria. The crowd was nearly brought to
tears by Addy’s story regarding the challenges she has been able to overcome
with her “teammate”—which is what she calls Gloria.

“I was extremely touched by Addy’s and Gloria’s
relationship. Not only is it clear how much Gloria has impacted Addy’s daily
life and her sense of self-worth, but the way that Gloria talks about Addy’s
influence on her own life is incredible. You can tell that Gloria was truly put
on this earth to be the nurturing, compassionate caregiver that she is,” said
Tara Montague.

Recently, Addy and Gloria visited Senator Steve Oroho to
share their story and to advocate for better state home care policies. “Helping people is important. And it’s
important that those who help others get the help that they need too,” Addy
told the group. Addy recommitted to continuing to advocate for herself and for others
who are impacted by home health care. “I
want to share my message with legislators. It’s my way of giving back,” she
said.

Lili and Emma Welcome Advocacy into Their Home

Photo: Lili and her nurse Barbara share a high five﻿

Next, Dave, Tara, and Alisa traveled to Morristown to visit home
care client Liliana “Lili” and her mother Emma in their home. As a single mom,
Emma relies on home nursing so that she can keep her full-time job and keep
Lili at home. She told us that her service office team works hard to ensure
that every one of Lili’s shifts are covered. She also shared about times when
that coverage wasn’t so steady: “Our
routine and our comfort level is only as good as today…When Lili’s main nurse
Liz retired, we had a few months where we didn’t know what tomorrow would
bring.”

Lili benefits from New Jersey’s private duty nursing (PDN) program,
which allows for children and adults with skilled care needs to live at home.
Without this program, it is unlikely that Lili would have been able to grow up
with her mom and graduate from school as she did. The PDN program’s rates need
to be raised in order to better attract more nurses to home care, as most can
currently make a higher wage delivering skilled care in a hospital or nursing
home. One of Hearts for Home Care’s
major advocacy goals for 2019 is to educate legislators on the need for a rate
increase and to secure one on behalf of all New Jersey home care clients,
families, and nurses.

Like Addy, Emma is committed to ongoing advocacy to ensure
that nurses see home care as an attractive employment option, so that other
families can receive the home care that they need too. In recent years, Emma has
hosted state elected officials in her home. “Seeing our daily routine and how
important it is for Lili to have a nurse at home is the most impactful way for
an assemblyman or senator to understand home care,” said Emma. “As a mother of someone who is able to stay
home due to in-home nursing care, I see it as my duty to advocate…Not just for Lili,
but for those in the state who are struggling to get the nursing they need.”

“It’s our clients’ and families’ voices that make the
biggest impact on our state and federal elected officials’ decisions about home
care. Because of advocates like Addy and
Emma, legislators better understand the impact home care has on their
communities,” said advocate Dave Totaro, who also serves as BAYADA’s chief
government affairs officer.

There are plenty of ways to advocate, even from home! To
find out ways that you can make an impact, contact us at advocacy@bayada.com. Together, we can
share our voices to make 2019 the best year for home care yet.

South Carolina State Representative Garry Smith (R, District 27) visited a local family in his district to learn how his constituents and many South Carolinian families rely on home care to keep their loved ones together at home and out of more expensive settings. Rep. Smith is one of the many legislators that Hearts for Home Care advocates bring into home care clients’ homes to show them how federal, state, and local policies affect home care recipients and their families.

During his visit, Rep. Smith met 21-month old BAYADA Home Health Care client Emma Ferguson, Emma’s mother Gina, and Emma’s in-home BAYADA Nurse Danielle Rian. Emma was born with a Chronic Lung Disease of Prematurity, which causes Emma to experience severe breathing problems, pain, and other symptoms. At her young age, Emma has already had several surgeries and currently still requires use of a Gastrostomy-Jejunostomy (G-J) Tube to assist with her feedings and medication management throughout the day. At birth, state Medicaid authorized Emma to receive private duty nursing (PDN) services in her home so that Emma can remain safely and comfortably at home with her mother.

In March, Emma’s PDN services were terminated when Medicaid determined that her skill level no longer qualified her to receive care in her home. From March until May, Emma attended a local day care facility for children with complex needs so that her mother could continue to work. During this time, Emma was hospitalized on several occasions and required ventilator support due to respiratory illness. In May 2018, Emma’s mother Gina reapplied for PDN services, and Emma was able to start receiving care at home again. Emma currently receives 32 hours of PDN services in her home, and since the reauthorization, she has not been readmitted to the hospital.

Emma’s mother Gina stated, “I’m grateful Rep. Smith was able to visit our home to see how Emma and other medically-complex children can grow up and thrive with in-home nursing. These kids deserve some normalcy in their lives, and I have seen first-hand how much better she does when she can be with me at home rather than in an institution. She only receives 32 hours a week, and this allows her to receive the care she needs in the best place–her home–and allows me to be able to work to support my family.”

After the home visit, Rep. Smith said, “visiting sweet Emma and her family has opened my eyes to what home care means to my constituents and to the many South Carolinians who depend on Medicaid home care to stay with their families and out of higher-cost settings. I look forward to exploring ways we can help keep families together while at the same time effectively managing the state’s budget.”

“One-on-one nursing services have allowed Emma to remain safely at home under the Medically Fragile Children’s Medicaid Nursing Waiver. This program is an alternative to nursing home placement at a lower cost to the state,” said Melissa Allman, Hearts for Home Care advocate and Director of Government Affairs for BAYADA. “In-home nursing care helps minimize deterioration and can prevent costly hospitalizations as staff can address subtle changes in the medical condition before it becomes serious. I hope that more legislators continue to learn about how cost-effective these services are to the state, and how valuable they are in keeping South Carolinian families together.”

Home visits like this one really give elected officials a better understanding of how their decisions on key issues like Medicaid impact real people who are seeking to remain safely at home with their families. To find out ways in which you can participate in a home visit with a local legislator, or other ways you can advocate, email advocacy@bayada.com.

As I reflect on 2017 and what we have accomplished, the first thing that comes to mind is Thank You.Thank you for your support, your engagement and your advocacy efforts — all of which made a difference in the lives of our clients, families and employees.

2017 was the “Year of Client Advocacy and Engagement.” Clients and families engaged lawmakers and the community at-large through home visits, family support group meetings, and phone calls and meetings with lawmakers in Trenton. These efforts ensured that our aides, nurses, and the importance of home care remained top of mind to New Jersey representatives and senators.

2017 was successful in many ways and set us up for even bigger wins in 2018. Below, please find a summary of 2017’s priorities and accomplishments:

• The Managed Medicaid Rate Floor bill was signed into law, effective July 1, 2018. The new law mandates a 100% pass-through of increased reimbursement to aides. In 2018 we will introduce a new bill which will be more reflective of a competitive wage environment and will mirror the original bill with no mandated pass-through.

• The Personal Care Assistant (PCA) fee-for-service rate was raised from $18.00 per hour to $19.00 per hour through a budget resolution, effective July 1, 2017.

• We successfully lobbied against Governor Christie’s intent to end the NJ/PA Reciprocity Tax agreement. This accomplishment saved our employees and BAYADA thousands of dollars in taxes.

• In July, the Private Duty Nursing (PDN) bill was introduced. This bill’s aim is to raise the PDN reimbursement rate by $10 per hour for RNs and LPNs. While the bill did not ultimately pass the state legislature in 2017, it brought awareness to the need for higher reimbursement rates within the program. We will continue to pursue this bill’s passage as a major goal for 2018.

• In conjunction with NJ’s Home Care Association, we successfully lobbied for legislation that permits physical therapy aides to practice in clients’ homes as long as the aides are supervised by a licensed physical therapist every two weeks.

• The BAYADA Champion Awards were held in December. This year we honored Lieutenant Governor-elect Sheila Oliver, Assemblywoman Nancy Munoz, Assemblyman Paul Moriarty and Senator-elect Declan O’Scanlon for their unwavering support of home care.

• BAYADA hosted a fundraiser for Senator-elect Troy Singleton, raising over $13,000 for his election fund.

• BAYADA reviewed and submitted comments to the state regarding the new 10:60 home care regulations.

Looking ahead to 2018, we will be working with Governor-elect Murphy and NJ legislators new and old to continue to advance home care and community-based services for our state’s neediest populations. GAO seeks to push for new laws to improve reimbursement rates within the PDN program, introduce legislation to provide technical changes to the current PCA managed care law, pursue minimum wage law changes, address parking challenges for our nurses and, of course, continue to advocate on behalf of our employees, clients and their families.

On July 13, Assemblyman Troy Singleton and Senate Majority Leader Loretta Weinberg introduced legislation A5089/S3400 which increases the New Jersey private duty nursing rate under State Fee-For-Service Medicaid by $10 per hour for registered nurses and licensed practical nurses. The last rate increase for private duty nursing was in 2008. BAYADA has been working with the Home Care Association and other providers discussing the need for a rate increase as it is difficult to recruit and retain nurses. BAYADA did an internal study and found of the scheduled hours, only 72% of those hours were filled, leaving clients and families without care.